water, sanitation and hygiene in health care...
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WASH in health care facilities – Water and Health Conference, UNC | 16 October 2014
Water, sanitation and hygiene
in health care facilities
Dr Rick Johnston
Water, Sanitation, Hygiene and Health Unit
WASH in health care facilities – Water and Health Conference, UNC | 16 October 2014
Context
WASH essential for preventing and treating disease in
health care facilities (HCF)
Health care associated infections in low income countries much
more prevalent than in Europe and US
In low income settings, an estimated 10-15% of maternal deaths are
due to infections that can be linked to unhygienic conditions
Many countries worldwide still lack basic WASH services
in HCFs
WASH in health care facilities – Water and Health Conference, UNC | 16 October 2014
Water source of a tuberculosis sanatorium in Uzbekistan Management of hospital waste in Pakistan
Source: AGUASAN, 2013
Examples
WASH in health care facilities – Water and Health Conference, UNC | 16 October 2014
WASH in HCF is different
Challenges
Lots of sick people
Lots of hazardous waste
Specific requirements due to limited
mobility of patients
Diversity of: – Users (patients, staff, visitors)
– Facilities (1°, 2°, 3°)
– Wastes (biological, chemical, radio.)
WASH – stuck between two sectors
Opportunities
Health care staff are highly
credible, can promote
hygiene behaviour change
Health facilities can
function as a role model for
proper management of
waste, water and
sanitation
WASH in health care facilities – Water and Health Conference, UNC | 16 October 2014
WHO’s role
Norms and guidelines
– Evidence-based
Support Member states
and partners in
implementation of
guidelines and monitoring
Advocacy and
partnerships
WASH in health care facilities – Water and Health Conference, UNC | 16 October 2014
An urgent priority
“Get your house in order!” M. Chan, 2013
WASH in health care facilities – Water and Health Conference, UNC | 16 October 2014
Where are we?
Essential Environmental Health Standards In Health
Care (2008)
Universal access to basic WASH in HCF by 2030 -
included in proposals and action plans in the context
of the post-2015 development agenda
WHO commissioned review of the global status of
WASH in HCF to guide those efforts and key actors
WHO/UNICEF Madrid meeting April 2014 – drafting
of a global action plan
WASH in health care facilities – Water and Health Conference, UNC | 16 October 2014
WHO normative guidelines
1. Water quality
2. Water quantity
3. Water facilities and access to water
4. Excreta disposal
5. Wastewater disposal
6. Health care waste disposal
7. Cleaning and laundry
8. Food storage and preparation
9. Building design, construction and management
10.Control of vector-borne disease
11.Information and hygiene promotion
Essential Environmental Health Standards in Health Care
WASH in health care facilities – Water and Health Conference, UNC | 16 October 2014
Global monitoring mechanisms
WHO/UNICEF Joint Monitoring Programme
Service Availability and Readiness Assessment
Rationale
UN-Water GLAAS: Global Analysis and Assessment of
Sanitation and Drinking-Water
WASH in health care facilities – Water and Health Conference, UNC | 16 October 2014
WHO/UNICEF Joint Monitoring Programme
on Water Supply and Sanitation (JMP)
WASH in health care facilities – Water and Health Conference, UNC | 16 October 2014
Service Availability and Readiness Assessment
(SARA)
A standard health facility assessment tool for
measuring Service Availability and Readiness
– Availability: Physical presence of services
– Readiness: Capacity to deliver services
Builds on experiences and best practices of other
surveys (e.g. SAM, SPA)
Routine system for annual verification of service
delivery (minimum service standards) and data at
facility level (public and private)
WASH in health care facilities – Water and Health Conference, UNC | 16 October 2014
UN-Water Global Analysis and Assessment of
Sanitation and Drinking-Water (GLAAS)
GLAAS objectives
– Monitor the inputs required to extend and sustain
WASH systems and services to all, especially the
unserved and disadvantaged groups
– Support country-led processes that bring together
the many institutions and actors that are involved in
delivering WASH services
– Identify drivers and bottlenecks of progress, highlight
knowledge gaps and assess strengths and
challenges across countries
Includes WASH in HCF questions on:
– Policy/plan development and implementation
– Policy and plan coverage targets
WASH in health care facilities – Water and Health Conference, UNC | 16 October 2014
Madrid, April 2014
40+ WASH and health professionals
– Governments, UN agencies, NGOs, development partners,
academia
Agreed on urgent need for concerted efforts
Drafting of global action plan
– Advocacy and partnerships
– Standards and policies
– Strengthening monitoring
– Research needs
WASH in health care facilities – Water and Health Conference, UNC | 16 October 2014
Moving forward
Global strategy for improving WASH in HCFs
– Advocacy and partnerships
– Linkages with other health and WASH initiatives
Supporting Member States and partners on the
implementation of Environmental Standards in Health
Care
Strengthening monitoring mechanisms
– Existing WHO monitoring systems (SARA, JMP, GLAAS)
– Ministries of Health - HMIS
WASH in health care facilities – Water and Health Conference, UNC | 16 October 2014
Resources
http://www.who.int/water_sanitation_health/
Essential Environmental Health Standards in Health Care (2008)
International strategic meeting to improve WASH services in health
care facilities,, Madrid. Meeting report. (2014)
Report on the global status of WASH and environmental conditions
in health care facilities in low income settings. (2014)
WASH in health care facilities – Water and Health Conference, UNC | 16 October 2014
Thanks!
Source: AGUASAN, 2013